제2형 당뇨병환자에서 족부병변의 발생률 및 위험인자 분석: 5년 관찰연구

박신애 ( Shin Ae Park ),고승현 ( Seung Hyun Ko ),이승환 ( Seung Hwan Lee ),조재형 ( Jae Hyoung Cho ),문성대 ( Sung Dae Moon ),장상아 ( Sang A Jang ),손현식 ( Hyun Shik Son ),송기호 ( Ki Ho Song ),차봉연 ( Bong Yun Cha ),손호영 ( H 대한당뇨병학회 2009 Diabetes and Metabolism Journal Vol.33 No.4

연구배경: 제 2형 당뇨병환자에서 당뇨병성 족부병변에 의한 하지절단은 지속적으로 증가하고 있다. 또한 당뇨병성 족부궤양 단계에서의 적절한 예방과 치료가 하지절단의 위험성을 50%나 감소시킨다고 보고된 바 있다. 본 연구는 당뇨병성 족부병변의 발생률과 임상양상 그리고 위험인자들을 살펴보고자 하였다. 방법: 2003년 1월부터 12월까지 가톨릭대학교 성빈센트병원에 내원한 제2형 당뇨병환자를 2008년까지 5년간 관찰하였다. 족부병변의 위험인자를 확인하기 위해 6개월 마다당화혈색소를 반복 측정하였고, 당뇨병성 합병증을 조사하였다. 자율신경병증은 Ewing 방법에 따라 반복적인 심호흡호기와 흡기 시 (E/I 비), 체위 변화 시(30:15 비), 발살바 수기 시 심박동수의 변화를 측정하였다. 신기능 저하를 확인하기 위해 단백뇨 여부와 MDRD GFR를 이용하였다. 결과: 총 646명의 대상 환자 중에서 연구기간을 완료한 환자는 508명(82.9%)이었고, 이 중 32명(6.3%)에서 당뇨병성 족부병변이 발생하였다. 당뇨병성 족부병변이 발생한 군에서는 당뇨병 유병기간이 길었고, 고혈압 동반률이 높았으며, 망막병증 동반율도 높았다. 연구기간 동안의 평균 당화혈색소도 발생군에서 높게 측정되었다. Lipoprotein (a)가 증가되거나 신기능이 저하된 경우 당뇨병성 족부병변의 발생이 증가함을 확인하였다. 무엇보다 심혈관계 자율신경병증의 동반은 당뇨병성 족부병변의 발생을 4배 가까이 증가시킴을 확인하였고, 이는 말초신경병증 못지않게 중요함을 알 수 있었다. 결론: 당뇨병성 족부병변의 발생과 가장 밀접한 관련이 있는 것은 평균 당화혈색소임을 확인하였다. 또한 신기능의 저하와 심혈관계 자율신경병증이 중요한 유발인자임을 확인하였다. 따라서 당뇨병성 족부병변의 발생을 예방하기 위해서는 엄격한 혈당조절뿐만 아니라 정기적인 신기능과 자율신경병증에 대한 정기적인 평가가 이뤄져야 할 것이다. Background: The frequency of lower extremity amputation due to diabetic foot has been increasing in type 2 diabetic patients. The aim of this study was to observe the incidence, clinical aspects and associated risk factors for diabetic foot. Methods: We evaluated the incidence of diabetic foot through a five-year observation of type 2 diabetic patients who presented to St. vincent`s Hospital between January and December 2003. To identify the risk factors for diabetic foot, we evaluated mean glycosylated hemoglobin A1c (HbA1c) every six months and assessed renal function based on the existence of proteinuria and estimated glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) equation. Patients were also evaluated for retinopathy, peripheral neuropathy and autonomic neuropathy using Ewing`s method. Results: From an initial pool of 613 patients, the observational study of 508 patients (82.9%) was completed. The mean age, duration of diabetes and HbA1c were 50.3±10.6 yrs, 7.2±6.5 yrs and 8.8±2.1%, respectively. Diabetic foot occurred in 32 patients (6.3%). The incidence of diabetic foot increased when diabetic retinopathy (OR=6.707, 2.314~19.439), peripheral neuropathy (OR=2.949, 1.075~8.090), and autonomic neuropathy (OR=3.967, 1.476~10.660) were present and when the MDRD GFR (OR=5.089, 1.712~15.130) decreased. Mean HbA1c (OR=12.013, 1.470~98.179) was found to be an independent risk factor for diabetic foot. Conclusion: The present study confirmed the importance of intensive glycemic control and the role of autonomic dysfunction in the development of diabetic foot. In addition, diabetic retinopathy and impaired renal function proved to be factors associated with the occurrence of diabetic foot. Therefore, intensive glycemic control, as well as periodic examination of renal function, are essential for the prevention of diabetic foot. (Korean Diabetes J 33:315-323, 2009)

Treatment of velopharyngeal insufficiency in a patient with a submucous cleft palate using a speech aid: the more treatment options, the better the treatment results

Park, Yun-Ha,Jo, Hyun-Jun,Hong, In-Seok,Leem, Dae-Ho,Baek, Jin-A,Ko, Seung-O Korean Association of Maxillofacial Plastic and Re 2019 Maxillofacial Plastic Reconstructive Surgery Vol.41 No.-

Background: The submucous cleft palate (SMCP) is a type of cleft palate that may result in velopharyngeal insufficiency (VPI). Palate muscles completely separate oral and nasal cavities by closing off the velopharynx during functional processes such as speech or swallow. Also, hypernasality may arise from anatomical or neurological abnormalities in these functions. Treatments of this issue involve a combination of surgical intervention, speech aid, and speech therapy. This case report demonstrates successfully treated VPI resulted from SMCP without any surgical intervention but solely with speech aid appliance and speech therapy. Case presentation: A 13-year-old female patient with a speech disorder from velopharyngeal insufficiency that was caused by a submucous cleft palate visited to our OMFS clinic. In the intraoral examination, the patient had a short soft palate and bifid uvula. And the muscles in the palate did not contract properly during oral speech. She had no surgical history such as primary palatoplasty or pharyngoplasty except for tonsillectomy. And there were no other medical histories. Objective speech assessment using nasometer was performed. We diagnosed that the patient had a SMCP. The patient has shown a decrease in speech intelligibility, which resulted from hypernasality. We decided to treat the patient with speech aid (palatal lift) along with speech therapy. During the 7-month treatment, hypernasality measured by a nasometer decreased and speech intelligibility became normal. Conclusions: Surgery remains the first treatment option for patients with velopharyngeal insufficiencies from submucous cleft palates. However, there were few reports about objective speech evaluation pre- or post-operation. Moreover, there has been no report of non-surgical treatment in the recent studies. From this perspective, this report of objective improvement of speech intelligibility of VPI patient with SMCP by non-surgical treatment has a significant meaning. Speech aid can be considered as one of treatment options for management of SMCP.

Semi-crystalline photovoltaic polymers with efficiency exceeding 9% in a ∼300 nm thick conventional single-cell device

Nguyen, T. L.,Choi, H.,Ko, S.-J.,Uddin, M. A.,Walker, B.,Yum, S.,Jeong, J.-E.,Yun, M. H.,Shin, T. J.,Hwang, S.,Kim, J. Y.,Woo, H. Y. The Royal Society of Chemistry 2014 ENERGY AND ENVIRONMENTAL SCIENCE Vol.7 No.9

<P>We report a series of semi-crystalline, low band gap (LBG) polymers and demonstrate the fabrication of highly efficient polymer solar cells (PSCs) in a thick single-cell architecture. The devices achieve a power conversion efficiency (PCE) of over 7% without any post-treatment (annealing, solvent additive, <I>etc.</I>) and outstanding long-term thermal stability for 200 h at 130 °C. These excellent characteristics are closely related to the molecular structures where intra- and/or intermolecular noncovalent hydrogen bonds and dipole–dipole interactions assure strong interchain interactions without losing solution processability. The semi-crystalline polymers form a well-distributed nano-fibrillar networked morphology with PC<SUB>70</SUB>BM with balanced hole and electron mobilities (a h/e mobility ratio of 1–2) and tight interchain packing (a π–π stacking distance of 3.57–3.59 Å) in the blend films. Furthermore, the device optimization with a processing additive and methanol treatment improves efficiencies up to 9.39% in a ∼300 nm thick conventional single-cell device structure. The thick active layer in the PPDT2FBT:PC<SUB>70</SUB>BM device attenuates incident light almost completely without damage in the fill factor (0.71–0.73), showing a high short-circuit current density of 15.7–16.3 mA cm<SUP>−2</SUP>. Notably, PPDT2FBT showed negligible changes in the carrier mobility even at ∼1 μm film thickness.</P> <P>Graphic Abstract</P><P>New semi-crystalline photovoltaic polymers were synthesized and the optimized device exhibited 9.39% efficiency in a ∼300 nm thick single-cell device. <IMG SRC='http://pubs.rsc.org/services/images/RSCpubs.ePlatform.Service.FreeContent.ImageService.svc/ImageService/image/GA?id=c4ee01529k'> </P>

중력주조 공법에서 주조해석 시뮬레이션을 이용한 압탕설계 사례 연구

고상배,한기원,김형준,한태수,한성렬,김경아,최계광,윤재웅,이춘규,Ko, Sang-Bae,Han, Ki-Won,Kim, Hyung-Jun,Han, Tae-Soo,Han, Seong-Ryeol,Kim, kyung-A,Choi, Kye-Kwang,Yun, Jae-Woong,Lee, Chun-Kyu 한국금형공학회 2021 한국금형공학회지 Vol.15 No.2

The casting method uses a mold to solidify a liquid metal to make a solid metal. Since it uses a liquid metal with the least deformation resistance, it has the characteristic that it can easily manufacture even a complex shape. However, the process of solidifying a liquid metal into a solid metal inevitably involves a volume change and contains internal defects such as shrinkage holes. Therefore, in the design of the casting plan, an excess volume called a pressurization compensates for the volume shrinkage. in the product, and it induces the shrinkage hole defects to occur in parts other than the product1). In this study, casting analysis was performed using casting analysis software (anycasting) in order to optimize the design of the tilting gravity casting method for automobile brackets. In particular, the filling and solidification analysis according to the shape and volume of the pressurized metal was conducted, and applied to the actual product to study the effect of the pressurized metal on the shrinkage defect. Through this study, it is possible to understand the effect of the pressure metal on shrinkage defects in the actual product and propose a design of the pressure metal that improves reliability and productivity.

Case Reports : Successful medical treatment of a pelvic abscess following a normal vaginal delivery: Report of a case and review of the Literature

( Byung Hun Kang ),( Heung Tae Noh ),( Ki Hwan Lee ),( Min A Lee ),( Young Bok Ko ),( Jung Bo Yang ),( Yun Ee Rhee ) 대한산부인과학회 2009 Journal of Womens Medicine Vol.2 No.3

The majority of puerperal infections are related to cesarean deliveries. A pelvic abscess complicating the puerperium after a vaginal delivery is rare and can be a diagnostic challenge. Abscess formation >4 weeks after vaginal delivery is very uncommon. Puerperal abscess formation is typically insidious, marked by diagnostic delay and requires surgical intervention. However, a single treatment with combination antibiotics is a viable option for patients with pelvic abscesses who show prompt clinical improvement. We describe a case involving the successful medical treatment of a pelvic abscess following a normal vaginal delivery with a review of the literature.

급성 골수성 백혈병에 동반된 IgA 신병증

김윤영 ( Yun Young Kim ),이호명 ( Ho Myung Lee ),황종운 ( Jong Woon Hwang ),이진호 ( Jin Ho Lee ),허종훈 ( Jong Hoon Heo ),권경아 ( Kyung A Kwon ),김성록 ( Sung Rok Kim ),고경혁 ( Gyung Hyuck Ko ) 대한신장학회 2006 Kidney Research and Clinical Practice Vol.25 No.5

The incidence of glomerulonephritis associated with malignancy is not common. Membranous glomerulonephritis associated with carcinomas and minimal change nephrotic syndrome with Hodgkin`s disease has been occasionally reported. The pathogenesis of glomerular injury associated with malignancy is not well known. The IgA nephropathy associated with malignancy, though rare, has been reported. IgA nephropathy associated with acute myeloid leukemia, however, is yet to be reported. We hereby report a case of IgA nephropathy associated with acute myeloid leukemia (AML M2). (Korean J Nephrol 2006;25(5):829-833)

Occurrence and fate of fetal lumbar rib induced by Scutellariae radix in rats

Ko, Eun A.,Park, Won Sun,Lim, Inja,Yun, Jihyun,Kim, Jung-Ha,Kang, Young-Ku,Kim, Nari,Han, Jin,Bang, Hyoweon,Ko, Jae-Hong Wiley Subscription Services, Inc., A Wiley Company 2010 Birth defects research. Part B, Developmental and Vol.89 No.3

<P>BACKGROUND: This study was conducted to evaluate the occurrence and fate of fetal lumbar rib induced by Scutellariae radix (SR) in rats. METHODS: Water extracts of SR were orally administered to pregnant rats from day 7 to day 17 of gestation at a dose of 186 mg/kg/day, equivalent to 25 g/kg of starting material, representing a 100-fold increase over typical human intake level. RESULTS: The incidence of fetal lumbar rib in the SR-treated group was increased on gestational day 20 and then decreased on postnatal day 50. The weight of fetuses in the SR-treated group tended to be less than that in the control group. Alkaline phosphatase in SR-treated dams was increased on gestational day 20, but was decreased on postnatal day 50. There were no significant differences between the vehicle control and SR-treated groups in maternal body weight, embryological, histopathological, hematological, and serum biochemical changes. CONCLUSIONS: The present data suggest that the appearance of lumbar rib induced by SR is a transient fetal variation rather than teratogenicity or maternal toxicity. Birth Defects Res (Part B) 89:201–206, 2010. © 2010 Wiley-Liss, Inc.</P>

Comparison of the anti-inflammatory effects of induced pluripotent stem cell-derived and bone marrow-derived mesenchymal stromal cells in a murine model of corneal injury

Yun, Young In,Park, Se Yeon,Lee, Hyun Ju,Ko, Jung Hwa,Kim, Mee Kum,Wee, Won Ryang,Reger, Roxanne L.,Gregory, Carl A.,Choi, Hosoon,Fulcher, Samuel F.,Prockop, Darwin J.,Oh, Joo Youn Elsevier 2017 cytotherapy Vol.19 No.1

<P>Background aims. Mesenchymal stromal cells (MSCs) offer tremendous potential for therapeutic applications for inflammatory diseases. However, tissue-derived MSCs, such as bone marrow derived MSCs (BM-MSCs), have considerable donor variations and limited expandability. It was recently demonstrated that MSCs derived from induced pluripotent stem cells (iPSC-MSCs) have less pro-tumor potential and greater expandability of homogenous cell population. In this study, we investigated the anti-inflammatory effects and mechanism of iPSC-MSCs in a murine model of chemical and mechanical injury to the cornea and compared the effects with those of BM-MSCs. Methods. To create an injury, ethanol was applied to the corneal surface in mice, and the corneal epithelium was removed with a blade. Immediately after injury, mice received an intravenous injection of (i) iPSC-MSCs, (ii) BM-MSCs or (iii) vehicle. Clinical, histological and molecular assays were performed in the cornea to evaluate inflammation. Results. We found that corneal opacity was significantly reduced by iPSC-MSCs or BM-MSCs. Histological examination revealed that the swelling and inflammatory infiltration in the cornea were markedly decreased in mice treated with iPSC-MSCs or BM-MSCs. Corneal levels of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta and IL-6 were lower in iPSC-MSC- and BM-MSC-treated mice, compared with vehicle-treated controls. In contrast, iPSC-MSCs with a knockdown of the TNF-alpha stimulating gene (TSG)-6 did not suppress the levels of inflammatory cytokines and failed to reduce corneal opacity. Conclusions. Together these data demonstrate that iPSC-MSCs exert therapeutic effects in the cornea by reducing inflammation in part through the expression of TSG-6, and the effects are similar to those seen with BM-MSCs.</P>

Immunosuppressive myeloid-derived suppressor cells can be converted into immunogenic APCs with the help of activated NKT cells: an alternative cell-based antitumor vaccine.

Ko, Hyun-Jeong,Lee, Jung-Mi,Kim, Yeon-Jeong,Kim, Yun-Sun,Lee, Kyoo-A,Kang, Chang-Yuil Williams Wilkins 2009 JOURNAL OF IMMUNOLOGY Vol.182 No.4

<P>Myeloid-derived suppressor cells (MDSCs), which are known to be accumulated in the blood, spleen, and bone marrow of tumor-bearing mice and cancer patients, were tested as APCs for a cellular vaccine because they have phenotypical similarity with inflammatory monocytes and may be differentiated from the same precursors as monocytes. Although MDSCs have immunosuppressive properties, in vivo transferred MDSCs, which present tumor Ag and NKT cell ligand (alpha-galactosylceramide), significantly prolonged survival time in metastatic tumor-bearing mice in a CD8(+) cell-, NK cell-, and NKT cell-dependent manner vs a CD4(+) T cell- and host dendritic cell-independent manner. Major concerns about using MDSCs as APCs in a vaccine are their suppression of CTLs and their induction of Foxp3(+) regulatory T cells. However, alpha-galactosylceramide-loaded MDSCs did not suppress CD4(+) and CD8(+) T cells and allowed for the generation of Ag-specific CTL immunity without increasing the generation of regulatory T cells. Furthermore, stimulation with activated NKT cells induced changes on MDSCs in phenotypical or maturation markers, including CD11b, CD11c, and CD86. Taken together, these findings suggest that NKT cells facilitate the conversion of immunosuppressive MDSCs into immunogenic APCs, eliciting successful antitumor immunity and providing the basis for alternative cell-based vaccines.</P>

제조조건에 따른 사삼병의 품질 특성

고윤아(Ko Yun-A),황인국(Hwang In-Guk),김진숙(Kim Jin-Sook),황영(Hwang, Young),유선미(Yoo Seon-Mi) 한국지역사회생활과학회 2011 한국지역사회생활과학회 학술대회 자료집 Vol.2011 No.10